Reversing the Adverse Cardiovascular Effects of Childhood Obesity Later in Life

Results of four large long-term studies indicate that adults who were obese during childhood can lower their cardiovascular risk by not being obese as adults.

Childhood obesity raises risk for obesity and cardiovascular disease during adulthood. To examine whether cardiovascular risks persist in obese children who are no longer obese as adults, researchers combined data from four longitudinal cohort studies (2 U.S., 1 Australian, and 1 Finnish) in which cardiovascular risk was tracked from childhood into adulthood in 6328 participants. Mean follow-up was 23 years, and adiposity status was based on body-mass index (BMI) measurements taken during childhood and adulthood.

Obese adults — regardless of childhood adiposity status — had significantly higher risk for hypertension, dyslipidemia, and type 2 diabetes mellitus than did participants who had never been obese as children or adults. However, normal-weight adults — regardless of childhood adiposity status — had similar cardiovascular risk as participants who had never been obese. Results were similar for men and women when different definitions of childhood adiposity were used.

Comment: These results suggest that obese children can lower their risk for cardiovascular disease if they achieve normal BMIs as adults. Therefore, it's never too late to encourage healthy lifestyles in our patients. We must identify the most effective interventions for preventing and treating childhood obesity as well as for helping patients maintain healthy weight as adults. As stated by an editorialist, "treating and preventing childhood obesity is a cost-effective way of achieving a long-term reduction in atherosclerotic cardiovascular disease."

— Louis M. Bell, MD
Published in Journal Watch Pediatrics and Adolescent Medicine November 16, 2011

CITATION(S):

Juonala M et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med 2011 Nov 17; 365:1876.

Rocchini AP. Childhood obesity and coronary heart diseases. N Engl J Med 2011 Nov 17; 365:1927.

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